Obsessive-Compulsive Disorder (OCD)!

Obsessive-Compulsive Disorder (OCD)

Symptoms, Treatment, and Self-Help

It’s normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But if you suffer from obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so consuming they interfere with your daily life. No matter what you do, you can’t seem to shake them. But help is available. With treatment and self-help strategies, you can break free of the unwanted thoughts and irrational urges and take back control of your life.

What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and ritualized, repetitive behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational—but even so, you feel unable to resist them and break free.

Like a needle getting stuck on an old record, OCD causes the brain to get stuck on a particular thought or urge. For example, you may check the stove 20 times to make sure it’s really turned off, or wash your hands until they’re scrubbed raw. While you don’t derive any sense of pleasure from performing these repetitive behaviors, they may offer some passing relief for the anxiety generated by the obsessive thoughts. You may try to avoid situations that trigger or worsen your symptoms or self-medicate with alcohol or drugs. But while it can seem like there’s no escaping your obsessions and compulsions, there are plenty of things you can do to help yourself and regain control of your thoughts and actions.

OCD obsessions and compulsions

Obsessions are involuntary thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas, but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.

Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive rituals and behaviors often end up causing anxiety themselves as they become more demanding and time-consuming. This is the vicious cycle of OCD.

Most people with OCD fall into one of the following categories:

Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.

Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.

Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen, or they will be punished.

Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.

Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use. They may also suffer from other disorders, such as depression, PTSD, compulsive buying, kleptomania, ADHD, skin picking, or tic disorders.

OCD signs and symptoms

Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. With OCD, these thoughts and behaviors cause tremendous distress, take up a lot of time (at least one hour per day), and interfere with your daily life and relationships.

Most people with obsessive-compulsive disorder have both obsessions and compulsions, but some people experience just one or the other.

Common obsessive thoughts in OCD include:

• Fear of being contaminated by germs or dirt or contaminating others
• Fear of losing control and harming yourself or others
• Intrusive sexually explicit or violent thoughts and images
• Excessive focus on religious or moral ideas
• Fear of losing or not having things you might need
• Order and symmetry: the idea that everything must line up “just right”
• Superstitions; excessive attention to something considered lucky or unlucky
• Common compulsive behaviors in OCD include:
• Excessive double-checking of things, such as locks, appliances, and switches
• Repeatedly checking in on loved ones to make sure they’re safe
• Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety
• Spending a lot of time washing or cleaning
• Ordering or arranging things “just so”
• Praying excessively or engaging in rituals triggered by religious fear
• Accumulating “junk” such as old newspapers or empty food containers

OCD symptoms in children

While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADHD, autism, and Tourette’s syndrome, can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made.

OCD self-help tip 1: Learn how to resist OCD rituals

No matter how overwhelming your OCD symptoms seem, there are many ways you can help yourself. One of the most powerful strategies is to eliminate the compulsive behaviors and rituals that keep your obsessions going.

Don’t avoid your fears. It might seem smart to avoid the situations that trigger your obsessive thoughts, but the more you avoid them, the scarier they feel. Instead, expose yourself to your OCD triggers, then try to resist or delay the urge to complete your relief-seeking compulsive ritual. If resistance gets to be too hard, try to reduce the amount of time you spend on your ritual. Each time you expose yourself to your trigger, your anxiety should lessen and you’ll start to realize that you have more control (and less to fear) than you think.

Anticipate OCD urges. By anticipating your compulsive urges before they arise, you can help to ease them. For example, if your compulsive behavior involves checking that doors are locked, windows closed, or appliances turned off, try to lock the door or turn off the appliance with extra attention the first time.

Create a solid mental picture and then make a mental note. Tell yourself, “The window is now closed,” or “I can see that the oven is turned off.”

When the urge to check arises later, you will find it easier to re-label it as “just an obsessive thought.”

Refocus your attention. When you’re experiencing OCD thoughts and urges, try shifting your attention to something else. You could exercise, jog, walk, listen to music, read, surf the web, play a video game, make a phone call, or knit. The important thing is to do something you enjoy for at least 15 minutes, in order to delay your response to the obsessive thought or compulsion. At the end of the delaying period, reassess the urge. In many cases, the urge will no longer be quite as intense. Try delaying for a longer period. The longer you can delay the urge, the more it will likely change.

Tip 2: Challenge obsessive thoughts

Everyone has troubling thoughts or worries from time to time. But obsessive-compulsive disorder causes the brain to get stuck on a particular anxiety-provoking thought, causing it to play over and over in your head. The following strategies can help you get unstuck.

Write down your obsessive thoughts or worries. Keep a pad and pencil on you, or type on a laptop, smartphone, or tablet. When you begin to obsess, write down all your thoughts or compulsions.

Keep writing as the OCD urges continue, aiming to record exactly what you’re thinking, even if you’re repeating the same phrases or the same urges over and over.

Writing it all down will help you see just how repetitive your obsessions are.

Writing down the same phrase or urge hundreds of times will help it lose its power.

Writing thoughts down is much harder work than simply thinking them, so your obsessive thoughts are likely to disappear sooner.

Create an OCD worry period. Rather than trying to suppress obsessions or compulsions, develop the habit of rescheduling them.

Choose one or two 10-minute “worry periods” each day, time you can devote to obsessing. Choose a set time and place (e.g. in the living room from 8:00 to 8:10 a.m. and 5:00 to 5:10 p.m.) that’s early enough it won’t make you anxious before bedtime.

During your worry period, focus only on negative thoughts or urges. Don’t try to correct them. At the end of the worry period, take a few calming breaths, let the obsessive thoughts or urges go, and return to your normal activities. The rest of the day, however, is to be designated free of obsessions and compulsions.

When thoughts or urges come into your head during the day, write them down and “postpone” them to your worry period. Save it for later and continue to go about your day.

Go over your “worry list” during the worry period. Reflect on the thoughts or urges you wrote down during the day. If the thoughts are still bothering you, allow yourself to obsess about them, but only for the amount of time you’ve allotted for your worry period.

Create a tape of your OCD obsessions. Focus on one specific worry or obsession and record it to a tape recorder, laptop, or smartphone.

Recount the obsessive phrase, sentence, or story exactly as it comes into your mind.

Play the tape back to yourself, over and over for a 45-minute period each day, until listening to the obsession no longer causes you to feel highly distressed.

By continuously confronting your worry or obsession you will gradually become less anxious. You can then repeat the exercise for a different obsession.